Stress, Coping, Health, & Optimal Aging

描述（由申请人提供）：压力和应对过程影响生物标志物，如血压，胆固醇分数，皮质醇在实验室设置，并在现场设置自我报告的健康。然而，建立压力-疾病的联系是非常困难的（Cohen等人，2007），部分原因是许多压力的流行病学研究对生活事件进行了单一的测量，这些测量充其量只是长期健康的弱预测因素。在规范老化研究中，我们已经收集了20多年的压力和应对数据，这提供了一个独特的机会来研究长期的压力模式（例如，慢性与间歇性与低）影响生物标志物的变化、心血管疾病的发展和死亡率，以及长期的心理健康轨迹。我们的理论模型提出，个人可以通过明智的压力管理，包括评估和应对过程，降低对疾病的脆弱性，促进最佳衰老。规范老化研究（NAS）是一项大型小组研究，研究开始于20世纪60年代，共有2，280名年龄在21至80岁之间的男性参与。1985年，我们开始研究生活事件，并于1989年开始收集，生活事件，麻烦和应对措施结合三年一度的生物医学考试。2001年，我们使用日记研究增加了日常压力源，并包括NAS妻子。2008年，我们在日常日记研究中加入了皮质醇。NAS中建议的额外数据收集将使我们能够利用纵向突发设计来研究慢性压力，日常压力，个性和生物标志物（如皮质醇昼夜节律和α淀粉酶）之间的相互作用。我们还将研究皮质醇反应性随时间的变化，这被认为是调节衰老速度的关键因素。第一个具体目标将是使用增长混合模型，模拟从中年到晚年的压力和应对过程的变化模式。其次，我们将研究这些不同模式对生物标志物变化的影响（例如，血压，胆固醇分数），以及心血管疾病的发展和死亡率。使用耦合分析，我们假设麻烦将更好地预测更近端的生物标志物的变化，而生活事件模式将更好地预测长期的健康结果。相反，积极应对将促进保持良好的心理健康以及HDL水平。第三个具体目标将检查慢性压力，个性，性别和年龄对皮质醇反应的影响。 公共卫生相关性：美国65岁以上的老年人口预计到2040年将几乎翻一番。由于老年人是迄今为止最大的医疗服务消费者，这可能会在不久的将来引发经济和公共卫生危机。了解促进最佳衰老的社会心理因素可能有助于减轻这些成本。

DESCRIPTION (provided by applicant): Stress and coping processes affect biomarkers such as blood pressure, cholesterol fractions, and cortisol in laboratory settings, and self-reported health in field settings. However, establishing the stress-illness link has been very difficult (Cohen et al., 2007), in part because many epidemiological studies of stress have single measures of life events which, at best, are only weak predictors of long-term health. At the Normative Aging Study, we have been collecting stress and coping data for 20+ years, which provides a unique opportunity to examine how patterns of stress over the long term (e.g., chronic vs. intermittent vs. low) affect changes in biomarkers, the development of cardiovascular disease, and mortality, as well as long-term mental health trajectories. Our theoretical model proposes that individuals can decrease vulnerability to disease and promote optimal aging through judicious management of stress, including appraisal and coping processes. The Normative Aging Study (NAS) is a large panel study of 2,280 men aged 21 to 80 at study onset in the 1960s. In 1985, we began studying life events, and in 1989 began collecting, life events, hassles and coping measures in conjunction with the triennial biomedical exams. In 2001, we added daily stressors using diary studies, and included NAS wives. In 2008 we added cortisol to the daily diary studies. The proposed additional data collection in the NAS will allow us to utilize a longitudinal burst design to examine the interplay among chronic stress, daily stress, personality, and biomarkers such as cortisol diurnal rhythms and alpha amylase in older men and women. We will also examine change in cortisol reactivity over time, thought to be a key factor modulating the rate of aging. The first specific aim will be to model patterns of change in stress and coping processes from middle-age to late life, using growth mixture models. Second, we will examine the impact of these different patterns on changes in biomarkers (e.g., blood pressure, cholesterol fractions), as well as the development of cardiovascular disease and mortality. Using coupling analyses, we hypothesize that hassles will better predict change in the more proximal biomarkers, while life event patterns will be better predictors of long-term health outcomes. In contrast, positive coping will promote the maintenance of good mental health as well as HDL levels. The third specific aim will examine the impact of chronic stress, personality, gender, and aging on cortisol reactivity. PUBLIC HEALTH RELEVANCE: The older population of Americans, age 65+, is expected to almost double by 2040. As older adults are by far the largest consumers of medical services, this threatens an economic and public health care crisis in the near future. Understanding the psychosocial factors that promote optimal aging may help to attenuate these costs.